Materiały źródłowe

• #1 Excoriation Disorder Workup: Approach Considerations, Diagnosis, Histologic Findings

  https://emedicine.medscape.com/article/1122042-workup

  A scale for evaluating skin picking, the Skin Picking Reward Scale (SPRS), helps to define a patient’s „wanting” and „liking” of skin picking. Initial findings validate the scale as a psychometrically sound measure. […] The American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), places excoriation (skin-picking) disorder in the category of obsessive-compulsive and related disorders and notes that it is characterized by recurrent body-focused repetitive behavior (skin picking) and repeated attempts to decrease or stop the behavior. […] The specific DSM-5-TR criteria for excoriation (skin-picking) disorder are as follows: Recurrent skin-picking, resulting in skin lesions; Repeated attempts to decrease or stop skin picking; The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning; The skin picking cannot be attributed to the physiologic effects of a substance (eg, cocaine) or another medical condition (eg, scabies); The skin picking cannot be better explained by the symptoms of another mental disorder (eg, delusions or tactile hallucinations [psychotic disorder], attempts to improve a perceived defect or flaw in ones appearance [body dysmorphic disorder], stereotypies [stereotypic movement disorder], or intention to harm oneself [nonsuicidal self-injury]).

• #1 Clinical Classification of Excoriation Disorder (skin picking disorder) | OCD-UK

  https://www.ocduk.org/related-disorders/skin-picking/clinical-classification-of-skin-picking/

  ICD-10 Until recently the original International Classification of Diseases (ICD) did not have a specific listing for Excoriation Disorder (skin picking) in ICD-10, it was sometimes coded under Factitial dermatitis (Neurotic excoriation) (Code: 98.1). However since the latest DSM-5 on the 1st October 2017, the World Health Organisation added Excoriation Disorder (skin picking) as a new category under OCD (Code: 42.4). […] The ICD-11 due to be published in 2018, will categorise Excoriation Disorder under Body-focused repetitive behaviour disorders which sits under Obsessive-compulsive or related disorders. […] With regard to the essential features of the draft ICD-11 manual it states the following diagnostic criteria for Excoriation disorder. […] Excoriation disorder is characterized by recurrent picking of ones own skin leading to skin lesions, accompanied by unsuccessful attempts to decrease or stop the behaviour. The most commonly picked sites are the face, arms and hands, but many individuals pick from multiple body sites. Skin picking may occur in brief episodes scattered throughout the day or in less frequent but more sustained periods. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

• #1

  https://link.springer.com/article/10.1007/s40263-019-00621-7

  Skin-picking disorder, also known as excoriation disorder or psychogenic skin excoriations, is an obsessive-compulsive and related disorder that is classified with other body-focused repetitive-behavior disorders in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). […] A full clinical and dermatologic examination and multidisciplinary approach is important in the diagnosis of this condition. […] There is no specific or recommended treatment option, but cognitive-behavioral therapy, particularly habit-reversal therapy and acceptance and commitment therapy have shown promise. Various pharmacological interventions have also been described to treat this condition in case reports and open and controlled trials. Specific classes of agents implemented include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors, antipsychotics, and glutaminergic-modulating agents. SSRIs and N-acetylcysteine have been shown to be the most effective of the pharmacological interventions.

• #1 Skin Picking Disorder (Excoriation): Symptoms, Treatment, and Causes

  https://www.webmd.com/mental-health/skin-picking-disorder

  Skin picking disorder is when you repeatedly and uncontrollably pick at your skin, sometimes resulting in injury and scarring. […] It’s classified in the DSM-V (a compendium of psychiatric diagnoses) as a type of obsessive-compulsive disorder (OCD) because of the compulsive urge to perform repetitive behaviors. However, skin picking disorder and OCD aren’t the same thing. […] Your doctor will usually use a few different methods to diagnose your condition, including: A physical exam to look for signs on your body, Questions about your medical history, life circumstances, and any behaviors that may be related, Diagnostic tests to help rule out other causes for your condition. […] To diagnose you with dermatillomania, your doctor will try to find out if you meet five criteria: Ongoing or repeated skin picking, You’ve made attempts to stop or cut down, You have shame, embarrassment, or other negative emotions about skin picking that affect your work and social life, You’re not picking your skin because of a medical or skin condition or the side effects of medicine or drugs, You don’t have another mental health condition that causes you to pick at your skin.

• #1 Excoriation Disorder: Practice Essentials, Background, Pathophysiology and Etiology

  https://emedicine.medscape.com/article/1122042-overview

  Excoriation (skin-picking) disorder, also known as psychogenic excoriation, dermatillomania, or neurotic excoriation, is characterized by the conscious repetitive picking of skin that leads to skin lesions and significant distress or functional impairment. […] Specific DSM-5-TR criteria for excoriation disorder are as follows: Recurrent skin-picking, resulting in lesions; Repeated attempts to decrease or stop skin picking; The skin picking causes clinically significant distress or impairment in important areas of functioning; The skin picking cannot be attributed to the physiologic effects of a substance or another medical condition; The skin picking cannot be better explained by the symptoms of another mental disorder. […] Diagnostic studies that may be considered for ruling out other conditions include the following: Complete blood count (CBC) with differential; Chemistry profile; Determination of thyrotropin levels; Fasting plasma glucose level; Cancer workup; Chest radiography; Skin biopsy.

• #1 Excoriation (Skin Picking) Disorder – PsychDB

  https://www.psychdb.com/ocd/excoriation

  Excoriation (Skin-Picking) Disorder is an obsessive-compulsive and related disorder characterized by the repeated urge to pick at one’s own skin, often to the extent that significant skin damage is caused. […] DSM-5 Diagnostic Criteria include: Recurrent skin picking resulting in skin lesions; Repeated attempts to decrease or stop skin picking; The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning; The skin picking is not attributable to the physiological effects of a substance or another medical condition; The skin picking is not better explained by symptoms of another mental disorder. […] The majority of individuals spend at least 1 hour per day picking, thinking about picking, and/or resisting urges to pick. […] Skin picking does not usually occur in the presence of other individuals, except in the presence immediate family members. […] Dermatopathological diagnosis is rarely required, but skin picking has characteristic features on histopathology.

• #1

  https://link.springer.com/article/10.1007/s12144-024-06300-1

  Excoriation (Skin Picking) Disorder (SPD) is a psychiatric condition characterized by repetitive skin picking, often affecting areas like the face, arms, and hands. It has its own diagnostic classification in ICD-10, DSM-5-TR and PDM-2. […] Validated assessment tools are essential for diagnosing and monitoring SPD symptoms. The Skin Picking Scale (SPS), Skin Picking Scale-Revised (SPS-R), Skin Picking Impact Scale (SPIS), and Skin Picking Symptom Assessment Scale (SP-SAS) are commonly used instruments for evaluating the severity of SPD symptoms. […] SPD is diagnosed when skin picking cannot be predominantly attributed to another medical issue such as scabies or acne. […] Diagnostic criteria for SPD diagnosis are synthetized in Table 1. The assessment must concentrate on the injuries, discomfort caused, and teasing-related disorders that can impact self-esteem and lead to social difficulties.

• #1 Assessing Excoriation (Skin-Picking) Disorder: Clinical Recommendations and Preliminary Examination of a Comprehensive Interview

  https://www.mdpi.com/1660-4601/19/11/6717

  Excoriation (skin-picking) disorder (SPD) is a psychiatric condition with variable clinical presentation. We developed the Diagnostic Interview for Skin Picking Problems (DISP), a semi-structured interview designed to assess (1) DSM-5 criteria for SPD and (2) several clinical features of SPD, including the frequency and duration of picking episodes, and the proportion of time devoted to picking at different body areas. The DISP was administered along with other measures to 120 college students (88% women, average age = 22 years) with suspected skin picking problems (based on their responses to a screening survey). The results showed that the DISP had good inter-rater reliability, test–retest reliability over 1–5 months, and convergent/divergent validity. We also found that participants displayed divergent clinical characteristics depending on the pattern of frequency, duration, and body location of picking episodes (e.g., those who primarily picked at the fingers had a unique clinical presentation). Overall, the findings provide preliminary support for the psychometric properties and clinical utility of DISP. The results also underscore the importance of accurately assessing frequency, duration, and body location of picking episodes.

• #1 Excoriation Disorder/ Dermatillomania/ Skin-picking Disorder: Symptoms, Causes, and Treatment – Los Angeles Outpatient Center

  https://laopcenter.com/mental-health/disorder/skin-picking/

  Dermatillomania is diagnosed based on the individuals symptoms and behavior patterns. A mental health professional will conduct an evaluation and use criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to make a diagnosis. […] The DSM-5 criteria for diagnosing Excoriation (Skin Picking) Disorder include several important components. Firstly, there must be recurrent skin picking that results in noticeable lesions. Secondly, individuals must have repeatedly attempted to decrease or stop this behavior. […] The diagnosis of Excoriation Disorder involves a comprehensive approach that combines established clinical criteria from the DSM-5 with structured interviews and self-report measures. […] Excoriation Disorder, commonly known as skin-picking disorder (SPD), is diagnosed through a structured process that includes clinical criteria as outlined in the DSM-5, as well as self-reporting and behavioral assessments, according to Snorrason I et al.s 2022 study Assessing Excoriation (Skin-Picking) Disorder published in the Environmental Research and Public Health Journal.

• #1 Excoriation disorder – Wikipedia

  https://en.wikipedia.org/wiki/Excoriation_disorder

  Because excoriation disorder is different from other conditions and disorders that cause picking of the skin, any diagnosis of excoriation disorder must take into account various other medical conditions as possible causes before diagnosing the patient with excoriation disorder. There are a variety of conditions that cause itching and skin picking including: eczema, psoriasis, diabetes, liver disease, Hodgkin’s disease, polycythemia vera, systemic lupus, and Prader-Willi syndrome. […] As of the release of the fifth Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013, this disorder is classified as its own separate condition under „Obsessive Compulsive and Related Disorders” and is termed „excoriation (skin-picking) disorder”. The diagnostic material is as follows: Repeated picking of the skin, resulting in injuries; Recurring attempts to stop picking while relapses continually occur; Picking causes a substantial amount of distress and substantially impairs everyday functioning; The picking is not caused or cannot be better explained by physiological effects of a substance or a medical disorder; The picking is not more accurately attributed to another mental disorder. […] Since the DSM-5 (2013), excoriation disorder is classified as „L98.1 Excoriation (skin-picking) disorder” in ICD-10; and is no longer classified in „Impulse control disorder” (f63).

• #1 Clinical Classification of Excoriation Disorder (skin picking disorder) | OCD-UK

  https://www.ocduk.org/related-disorders/skin-picking/clinical-classification-of-skin-picking/

  The essential feature of excoriation (skin-picking) disorder is recurrent picking at ones own skin (Criterion A). […] Criterion C indicates that skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. […] Excoriation disorder is associated with distress as well as with social and occupational impairment. […] Most individuals with excoriation disorder admit to skin picking; therefore, dermatopathological diagnosis is rarely required. […] Excoriation disorder is often accompanied by other mental disorders.

• #1 Excoriation Disorder: Assessment, Diagnosis and Treatment – The Professional Counselor

  https://tpcjournal.nbcc.org/excoriation-disorder-assessment-diagnosis-and-treatment/

  It is important that counselors have a thorough understanding of the DSM-5 criteria for excoriation disorder and understand that many clients with this disorder might hide physical markers and omit skin picking information unless asked directly (Grant Odlaug, 2009). […] A thorough assessment helps counselors to identify an accurate diagnosis. […] In order to accurately diagnose the disorder, counselors must be familiar with the DSM-5 diagnostic criteria and understand diagnostic considerations related to the disorder. […] The general features that a counselor should look for when diagnosing excoriation disorder include a preoccupation with picking behaviors, difficulty in controlling the behaviors and distress resulting from the behaviors. […] Ultimately, excoriation disorder is characterized by recurrent and excessive tissue damage that is not better accounted for by nonsuicidal self-injury. Those who have excoriation disorder have difficulty controlling their picking behaviors and experience clinically significant distress or impairment as a result of these behaviors (APA, 2013).

• #1 Excoriation disorder – Wikipedia

  https://en.wikipedia.org/wiki/Excoriation_disorder

  Excoriation disorder can cause feelings of intense helplessness, guilt, shame, and embarrassment in individuals, and this greatly increases the risk of self-harm. Studies have shown that excoriation disorder presented suicidal ideation in 12% of individuals with this condition, suicide attempts in 11.5% of individuals with this condition, and psychiatric hospitalizations in 15% of individuals with this condition. […] There has been controversy over the creation of a separate category in the DSM-5 for excoriation (skin picking) disorder. Two of the main reasons for objecting to the inclusion of excoriation disorder in the DSM-5 are: that excoriation disorder may just be a symptom of a different underlying disorder, e.g. OCD or BDD, and excoriation disorder is merely a bad habit and that by allowing this disorder to obtain its own separate category it would force the DSM to include a wide array of bad habits as separate syndromes, e.g., nail-biting, nose-picking, hair pulling, etc.

• #1 Skin Picking Disorder Test (Dermatillomania)

  https://peachtreewellnessmh.com/online-mental-health-assessments/skin-picking-disorder-test/

  Early recognition and intervention are crucial, as the condition rarely improves without treatment and may worsen during periods of increased stress or when comorbid conditions such as anxiety or depression are present. […] Effective treatment for Excoriation Disorder typically involves a multifaceted approach tailored to the individual’s specific needs and circumstances. […] At Peachtree Wellness Solutions, we offer comprehensive, evidence-based treatment options designed to address both the picking behaviors and their underlying causes. […] Treatment outcomes are significantly improved when individuals receive proper support and comprehensive care. […] Many individuals find that a combination of therapy, medication when appropriate, and practical strategies offers the most effective path to recovery and long-term management of skin picking behaviors.

• #1 Excoriation disorder diagnosis: How it’s done and the importance of accuracy | SkinPick.com

  https://www.skinpick.com/excoriation-disorder-diagnosis-how-its-done-and-why-its-relevant

  Still a misunderstood condition, research is providing more ways for clinicians to diagnose excoriation disorder and its subtypes accurately. […] Regardless of ones therapeutic perspective, an accurate diagnosis is key to selecting evidence-based treatments for clients. For people with skin picking disorder, diagnosis can be even more important due to the prevalence of misdiagnosis which does not help clients at all. […] Accurate diagnosis serves a clinical purpose in that it drives treatment. […] Accurate diagnosis of dermatillomania is not only important for correctly identifying the disorder but identifying subtypes and severity can inform treatment, so it is helpful and not harmful. For a person who struggles with compulsive skin picking, an accurate diagnosis can be a source of hope.

• #2

  https://link.springer.com/article/10.1007/s40263-019-00621-7

  Skin-picking disorder, also known as excoriation disorder or psychogenic skin excoriations, is an obsessive-compulsive and related disorder that is classified with other body-focused repetitive-behavior disorders in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). […] A full clinical and dermatologic examination and multidisciplinary approach is important in the diagnosis of this condition. […] There is no specific or recommended treatment option, but cognitive-behavioral therapy, particularly habit-reversal therapy and acceptance and commitment therapy have shown promise. Various pharmacological interventions have also been described to treat this condition in case reports and open and controlled trials. Specific classes of agents implemented include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors, antipsychotics, and glutaminergic-modulating agents. SSRIs and N-acetylcysteine have been shown to be the most effective of the pharmacological interventions.

• #2 Table 3.28, Excoriation (Skin Picking) Disorder – Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t28/

  DSM-5: Excoriation (skin picking) disorder Disorder Class: Obsessive-Compulsive and Related Disorders Recurrent skin picking resulting in skin lesions Repeated attempts to decrease or stop skin picking The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning The skin picking is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., scabies) The skin picking is not better explained by symptoms of another mental disorder (e.g., delusions or tactile hallucinations in a psychotic disorder, attempts to improve a perceived defect or flaw in body dysmorphic disorder, stereotypies in stereotypic movement disorder, or intention to harm oneself in nonsuicidal self-injury). […] NOTE: DSM-IV does not have criteria for this disorder, so no comparison is made.

• #2 F42.4 – ICD-10 code for excoriation (skin-picking) disorder

  https://www.upheal.io/icd-10-codes/excoriation-disorder-skin-picking

  The ICD-10 code for excoriation disorder is F42.4. This code appears within the obsessive-compulsive and related disorders section, reflecting our modern understanding of skin picking as a body-focused repetitive behavior with both compulsive and impulsive features. […] Healthcare providers should use this code when documenting cases where patients demonstrate: Recurrent skin picking leading to tissue damage, Multiple attempts to decrease or stop picking behavior, Clinically significant distress or functional impairment, Symptoms not better explained by another mental disorder or medical condition. […] Evidence-based psychotherapy remains the primary treatment approach, with cognitive-behavioral therapy (CPT) and exposure and response prevention (ERP) being common modalities for skin-picking disorder. […] The impact of excoriation disorder extends beyond physical scarring to affect social relationships, occupational functioning, and emotional well-being.

• #2 2025 ICD-10-CM Diagnosis Code F42.4: Excoriation (skin-picking) disorder

  https://www.icd10data.com/ICD10CM/Codes/F01-F99/F40-F48/F42-/F42.4

  F42.4 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. […] The 2025 edition of ICD-10-CM F42.4 became effective on October 1, 2024. […] A type 1 excludes note indicates that the code excluded should never be used at the same time as F42.4. […] Type 1 Excludes: L98.1 ICD-10-CM Diagnosis Code L98.1 […] Type 1 Excludes: Excoriation (skin-picking) disorder (F42.4). […] skin picking disorder F42.4.

• #2 Excoriation Disorder: Assessment, Diagnosis and Treatment – The Professional Counselor

  https://tpcjournal.nbcc.org/excoriation-disorder-assessment-diagnosis-and-treatment/

  It is important that counselors have a thorough understanding of the DSM-5 criteria for excoriation disorder and understand that many clients with this disorder might hide physical markers and omit skin picking information unless asked directly (Grant Odlaug, 2009). […] A thorough assessment helps counselors to identify an accurate diagnosis. […] In order to accurately diagnose the disorder, counselors must be familiar with the DSM-5 diagnostic criteria and understand diagnostic considerations related to the disorder. […] The general features that a counselor should look for when diagnosing excoriation disorder include a preoccupation with picking behaviors, difficulty in controlling the behaviors and distress resulting from the behaviors. […] Ultimately, excoriation disorder is characterized by recurrent and excessive tissue damage that is not better accounted for by nonsuicidal self-injury. Those who have excoriation disorder have difficulty controlling their picking behaviors and experience clinically significant distress or impairment as a result of these behaviors (APA, 2013).

• #2 Skin Picking Disorder (Excoriation): Symptoms, Treatment, and Causes

  https://www.webmd.com/mental-health/skin-picking-disorder

  There is no one test for dermatillomania. Your doctor may do medical tests so they can rule out medical causes for your symptoms. Generally, your doctor can tell if you have it from your medical history, your symptoms, and a physical exam. They may also refer you to a specialist for diagnosis and treatment.

• #2 Excoriation Disorder Workup: Approach Considerations, Diagnosis, Histologic Findings

  https://emedicine.medscape.com/article/1122042-workup

  Associated features supporting the diagnosis include a range of behaviors or rituals involving the skin that has been picked. Examples include examining, playing with or even swallowing the skin after it has been pulled off. Picking can be accompanied by different emotional states. The act of picking can be triggered by anxiety or boredom and be preceded by a sense of tension. Afterwards individuals might feel a sense of pleasure, relief or gratification. Pain is not routinely reported.

• #2 Excoriation (Skin-Picking) Disorder – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/obsessive-compulsive-and-related-disorders/excoriation-skin-picking-disorder

  Excoriation disorder is characterized by recurrent picking of one’s skin, resulting in skin lesions. […] To meet diagnostic criteria for excoriation disorder, patients must typically cause visible skin lesions by picking (although some patients try to camouflage lesions with clothing or makeup). […] Patients with excoriation disorder repeatedly try to stop picking their skin or to pick less often, but they are unable to do so. […] Excoriation disorder causes visible skin lesions.

• #2 Skin Picking Disorder Test: Dermatillomania SymptomsFooterLogo

  https://www.additudemag.com/skin-picking-disorder-dermatillomania-test/?srsltid=AfmBOoo47tBG7Ne7QV7DCALcTWeyp35xMERfFmosIXyc5BeYvjfYopW3

  Skin-picking disorder, also known as excoriation disorder or dermatillomania, is one of the most common body-focused repetitive behaviors (BFRBs). Individuals with this condition recurrently pick at their skin, often from multiple sites of the body, including the face, arms, and/or fingers/hands. Skin picking results in lesions, which many individuals attempt to conceal with clothing and/or makeup. Skin-picking disorder affects about 5% of people, and often occurs with conditions like depression, anxiety, and ADHD. […] Skin-picking disorder, if untreated, can cause significant distress and impact an individual’s functioning in multiple areas of life, from work and social activities. The condition can also lead to complications like scarring, infection, and tissue damage. […] This self-test is designed to screen for the possibility of excoriation disorder (skin-picking disorder), and it is intended for personal use only. This self-test is not intended as a diagnostic tool.

• #2

  https://link.springer.com/article/10.1007/s12144-024-06300-1

  In particular, SPD can be diagnosed using clinical interviews or standardized assessment tools capable of evaluating the severity and types of teasing behavior. These materials can also aid clinicians during screening and treatment monitoring. […] The only validated clinician-rated available tool for SPD diagnosis according to DSM-5 criteria is the DISP, which has been recently validated on preliminary data and results support its psychometric accuracy and clinical utility.

• #2 Assessing Excoriation (Skin-Picking) Disorder: Clinical Recommendations and Preliminary Examination of a Comprehensive Interview

  https://www.mdpi.com/1660-4601/19/11/6717

  We suggest that in addition to the DSM-5 criteria, two clinical features are particularly useful in the assessment of SPD. First, it is important to accurately assess how much time the person spends picking at their skin. According to the DSM-5 criteria, “recurrent” skin picking is required for diagnosis of SPD, but the exact amount is not specified. […] We therefore recommend assessing not only the overall duration of skin picking but also the frequency and duration of episodes. […] We administered the DISP to a sample of college students with suspected SPD (based on their responses to an online self-report screening survey) and examined inter-rater reliability, test–retest reliability, and construct validity. […] The results provided preliminary support for the psychometric properties of the interview. We found evidence for convergent validity as core items/indices of this new instrument (e.g., DSM-5 diagnosis and total picking duration) had moderate correspondence with a previously validated measure of the same constructs (the SPS-R). We also found evidence for discriminant validity as these core DISP items/indices were relatively unrelated to valid measures of overlapping but distinct constructs, including negative affect, obsessive compulsive symptoms, and skin complaints. Additionally, the results showed excellent inter-rater agreement for each of the diagnostic item as well as the full DSM-5 SPD diagnosis.

• #2 Assessing Excoriation (Skin-Picking) Disorder: Clinical Recommendations and Preliminary Examination of a Comprehensive Interview

  https://www.mdpi.com/1660-4601/19/11/6717

  The DISP is a comprehensive diagnostic interview designed to assess DSM-5 diagnosis and clinical features of SPD. This initial study suggests that the DISP has good inter-rater and test–retest reliability as well as acceptable construct validity among college students with SPD. We believe the DISP can be used in general and clinical settings by trained interviewers. The results highlight the utility of going beyond the DSM-5 criteria and accurately assess the duration, frequency, and body location of picking episodes.

• #2 Excoriation Disorder: Practice Essentials, Background, Pathophysiology and Etiology

  https://emedicine.medscape.com/article/1122042-overview

  Excoriation (skin-picking) disorder, also known as psychogenic excoriation, dermatillomania, or neurotic excoriation, is characterized by the conscious repetitive picking of skin that leads to skin lesions and significant distress or functional impairment. […] Specific DSM-5-TR criteria for excoriation disorder are as follows: Recurrent skin-picking, resulting in lesions; Repeated attempts to decrease or stop skin picking; The skin picking causes clinically significant distress or impairment in important areas of functioning; The skin picking cannot be attributed to the physiologic effects of a substance or another medical condition; The skin picking cannot be better explained by the symptoms of another mental disorder. […] Diagnostic studies that may be considered for ruling out other conditions include the following: Complete blood count (CBC) with differential; Chemistry profile; Determination of thyrotropin levels; Fasting plasma glucose level; Cancer workup; Chest radiography; Skin biopsy.

• #2 Excoriation (Skin Picking) Disorder – PsychDB

  https://www.psychdb.com/ocd/excoriation

  Excoriation (Skin-Picking) Disorder is an obsessive-compulsive and related disorder characterized by the repeated urge to pick at one’s own skin, often to the extent that significant skin damage is caused. […] DSM-5 Diagnostic Criteria include: Recurrent skin picking resulting in skin lesions; Repeated attempts to decrease or stop skin picking; The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning; The skin picking is not attributable to the physiological effects of a substance or another medical condition; The skin picking is not better explained by symptoms of another mental disorder. […] The majority of individuals spend at least 1 hour per day picking, thinking about picking, and/or resisting urges to pick. […] Skin picking does not usually occur in the presence of other individuals, except in the presence immediate family members. […] Dermatopathological diagnosis is rarely required, but skin picking has characteristic features on histopathology.

• #2 Common Misdiagnoses for Excoriation Disorder – Skin Picking Support

  https://www.skinpickingsupport.com/blog/common-misdiagnoses-for-excoriation-disorder/

  With excoriation disorder (aka skin picking, or, dermatillomania) only being recognized as an independent mental health disorder in 2013, misdiagnoses of this compulsion is still common. […] To better categorize obsessions and compulsions, the DSM-5 includes a new Obsessive-Compulsive and Related Disorders section, where excoriation disorder is found. […] If you are seeking a diagnosis from a professional, a dermatologist can rule out possible skin conditions. Psychologists, psychotherapists, and psychiatrists are qualified to determine if your skin picking is caused by excoriation disorder or if it is better explained as a symptom of another mental health condition.

• #2 Skin picking disorder | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/12/clinical-review/skin-picking-disorder

  Skin picking disorder is classified as an obsessive-compulsive and related disorder. The diagnosis requires significant emotional distress or impaired functioning in at least one important area of life (academic, occupational or social). […] The diagnosis of skin picking disorder should not normally be used if the skin picking is better explained by other disorders. Nevertheless, a secondary diagnosis of skin picking disorder may be made if the patient perceives that the picking causes problems. If in doubt, clarification with a dermatologist or psychiatrist would be beneficial.

• #2 Excoriation disorder diagnosis: How it’s done and the importance of accuracy | SkinPick.com

  https://www.skinpick.com/excoriation-disorder-diagnosis-how-its-done-and-why-its-relevant

  Still a misunderstood condition, research is providing more ways for clinicians to diagnose excoriation disorder and its subtypes accurately. […] Regardless of ones therapeutic perspective, an accurate diagnosis is key to selecting evidence-based treatments for clients. For people with skin picking disorder, diagnosis can be even more important due to the prevalence of misdiagnosis which does not help clients at all. […] Accurate diagnosis serves a clinical purpose in that it drives treatment. […] Accurate diagnosis of dermatillomania is not only important for correctly identifying the disorder but identifying subtypes and severity can inform treatment, so it is helpful and not harmful. For a person who struggles with compulsive skin picking, an accurate diagnosis can be a source of hope.

• #2 Excoriation Disorder/ Dermatillomania/ Skin-picking Disorder: Symptoms, Causes, and Treatment – Los Angeles Outpatient Center

  https://laopcenter.com/mental-health/disorder/skin-picking/

  Dermatillomania is diagnosed based on the individuals symptoms and behavior patterns. A mental health professional will conduct an evaluation and use criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to make a diagnosis. […] The DSM-5 criteria for diagnosing Excoriation (Skin Picking) Disorder include several important components. Firstly, there must be recurrent skin picking that results in noticeable lesions. Secondly, individuals must have repeatedly attempted to decrease or stop this behavior. […] The diagnosis of Excoriation Disorder involves a comprehensive approach that combines established clinical criteria from the DSM-5 with structured interviews and self-report measures. […] Excoriation Disorder, commonly known as skin-picking disorder (SPD), is diagnosed through a structured process that includes clinical criteria as outlined in the DSM-5, as well as self-reporting and behavioral assessments, according to Snorrason I et al.s 2022 study Assessing Excoriation (Skin-Picking) Disorder published in the Environmental Research and Public Health Journal.

• #2 Picking your skin? Learn four tips to break the habit – Harvard Health

  https://www.health.harvard.edu/blog/picking-your-skin-learn-four-tips-to-break-the-habit-2018112815447

  If you cant stop picking your skin, you may have a very common condition called skin picking disorder (SPD). […] A diagnosis of SPD, also known as excoriation disorder, is made when there are repeated attempts to stop picking, and the skin picking is either distressing or interfering with social or work functioning. […] Cognitive behavioral therapy (CBT) is a structured type of psychotherapy that aims to produce healthier behaviors and beliefs by identifying unhelpful thoughts and behaviors. A specialized type of CBT has been developed for SPD. […] While no medication has been formally approved by the FDA to treat excoriation disorder, there is evidence to suggest that selective serotonin reuptake inhibitor (SSRI) antidepressants and N-acetylcysteine (NAC), an antioxidant supplement, can be helpful.

• #3 Clinical Classification of Excoriation Disorder (skin picking disorder) | OCD-UK

  https://www.ocduk.org/related-disorders/skin-picking/clinical-classification-of-skin-picking/

  In DSM-5, Excoriation (Skin Picking) Disorder sits under its own category of Obsessive-Compulsive and Related Disorders and within that the following subcategories were placed: […] In terms of the actual diagnostic criteria the DSM-5 lists the following: […] A. Recurrent skin picking resulting in skin lesions. B. Repeated attempts to decrease or stop skin picking. C. The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The skin picking is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., scabies). E. The skin picking is not better explained by symptoms of another mental disorder (e.g., delusions or tactile hallucinations in a psychotic disorder, attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder, stereotypies in stereotypic movement disorder, or intention to harm oneself in nonsuicidal self-injury).

• #4 Excoriation Disorder: Practice Essentials, Background, Pathophysiology and Etiology

  https://emedicine.medscape.com/article/1122042-overview

  Excoriation (skin-picking) disorder, also known as psychogenic excoriation, dermatillomania, or neurotic excoriation, is characterized by the conscious repetitive picking of skin that leads to skin lesions and significant distress or functional impairment. […] Specific DSM-5-TR criteria for excoriation disorder are as follows: Recurrent skin-picking, resulting in lesions; Repeated attempts to decrease or stop skin picking; The skin picking causes clinically significant distress or impairment in important areas of functioning; The skin picking cannot be attributed to the physiologic effects of a substance or another medical condition; The skin picking cannot be better explained by the symptoms of another mental disorder. […] Diagnostic studies that may be considered for ruling out other conditions include the following: Complete blood count (CBC) with differential; Chemistry profile; Determination of thyrotropin levels; Fasting plasma glucose level; Cancer workup; Chest radiography; Skin biopsy.

• #5 Excoriation (Skin Picking) Disorder – PsychDB

  https://www.psychdb.com/ocd/excoriation

  Excoriation (Skin-Picking) Disorder is an obsessive-compulsive and related disorder characterized by the repeated urge to pick at one’s own skin, often to the extent that significant skin damage is caused. […] DSM-5 Diagnostic Criteria include: Recurrent skin picking resulting in skin lesions; Repeated attempts to decrease or stop skin picking; The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning; The skin picking is not attributable to the physiological effects of a substance or another medical condition; The skin picking is not better explained by symptoms of another mental disorder. […] The majority of individuals spend at least 1 hour per day picking, thinking about picking, and/or resisting urges to pick. […] Skin picking does not usually occur in the presence of other individuals, except in the presence immediate family members. […] Dermatopathological diagnosis is rarely required, but skin picking has characteristic features on histopathology.

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